Provider Demographics
NPI:1538390653
Name:SLEEP UNLIMITED COOKEVILLE
Entity type:Organization
Organization Name:SLEEP UNLIMITED COOKEVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:EALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-758-2838
Mailing Address - Street 1:764 WALNUT KNOLL LN
Mailing Address - Street 2:SUITE200
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3113
Mailing Address - Country:US
Mailing Address - Phone:901-758-2838
Mailing Address - Fax:901-758-2479
Practice Address - Street 1:1150 PERIMETER PARK DR
Practice Address - Street 2:SUITE D
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0927
Practice Address - Country:US
Practice Address - Phone:901-758-2838
Practice Address - Fax:901-758-2479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic